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Biomedical subjects

G Primo

Publications and source records attributed to G Primo.

At least 37 records · Page 2Linked to original sources
PubMed1987

Human heart-lung transplantation: physiologic aspects of the denervated lung and post-transplant obliterative bronchiolitis.

Eighteen sequential follow-up measurements of pulmonary function were obtained over a period of 21 months after heart-lung transplantation in a patient who had undergone surgery for end-stage pulmonary lymphangioleiomyomatosis. In the early postoperative period, there was a moderate decrease in VC and TLC but gas exchange was maintained at essentially normal levels. The most conspicuous features of postoperative lung function were a very low airway resistance and an increase in FEV1/VC ratio above 95%. These alterations were associated with an unusual shape of the maximal expiratory flow-volume (MEFV) curve. Instead of showing a uniform decrease in expiratory flow as expiration proceeds to residual volume, the post-transplant MEFV curve showed a peak followed by a gently sloping plateau ending at a knee where flow suddenly fell. The knee occurred after exhalation of 80% VC. From the sixth postoperative month, the patient developed rapidly increasing air-flow obstruction, which proved to be due to obliterative bronchiolitis. As air-flow obstruction worsened, the knee on the MEFV curve progressively occurred at a higher lung volume, the flow plateau shortened, and flow after the knee became smaller at a given volume. From the ninth postoperative month, it was no longer possible to identify a plateau-knee configuration on the MEFV curve, which resembled that seen in severe obstructive airway disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

Aortico-left ventricular tunnel (ALVT). A diagnostic and surgical "must".

ALVT is a rare congenital lesion. The paravalvular tunnel causes a clinical picture of aortic regurgitation. An aortic regurgitant murmur is present since birth. The clinical diagnosis, often overlooked, is best confirmed by angiocardiography in the lateral view. Although 80% of reported cases present with congestive heart failure before age 1, our two cases were asymptomatic at age 13 and 8 respectively. Both were operated on the basis of progressive left ventricular (L.V.) overload and dilatation. Diagnosis was made at operation in case 1 and suspected by the surgeon in case 2. Case 1 necessitated implantation of a bioprosthetic valve and replacement of the prosthesis 3 years later for primary tissue failure. Case 2 could be handled more conservatively with obturation of the aortic orifice of the tunnel. The natural evolution of the lesion involves progressive aortic valve regurgitation both by annuloectasia and retraction of the valve cusps. The diagnosis of ALVT should be considered in any infant or child with an aortic regurgitation murmur. Surgical treatment should be undertaken before alteration of the valve and the aim should be preservation of native valve function.

Adolescent↗
PubMed1986

[Effects of physical training on the denervated human heart after orthotopic cardiac transplantation].

Three patients who had undergone an orthotopic cardiac transplantation followed a course of supervised intermittent physical training (60 to 80 per cent of the maximum load) involving three weekly sessions of thirty minutes, for a period of 150 +/- 80 days. During maximal effort, we observed increases of 50 per cent in the load in watts (0.05 less than p less than 0.1), 40 per cent in oxygen consumption (0.1 less than p less than 0.2), 10 per cent in heart rate (p = 0.5) and 21 per cent in systolic blood pressure (0.7 less than p less than 0.8). The respiratory equivalent for oxygen decreased by 21 per cent (0.025 less than p less than 0.05) and the respiratory quotient by 5 per cent (0.4 less than p less than 0.05). For a given submaximal effort (30 watts) the following decreases were observed: 9 per cent in oxygen consumption (V'O2) (0.1 less than p less than 0.2), 32 per cent in the minute ventilation (V'E) (0.05 less than p less than 0.1), 22 per cent in the respiratory equivalent for oxygen (REO2) (0.025 less than p less than 0.05), 8 per cent in the respiratory quotient (RQ) (0.2 less than p less than 0.3) and 11 per cent in the heart rate (HR) (0.1 less than p less than 0.2). The systolic blood pressure (SBP) increased by 6 per cent (0.2 less than p less than 0.3). No changes were observed in these parameters in the postoperative follow-ups (10 to 24 months) of two patients who did not undergo physical training. Physical training is, therefore, necessary in the process of physical readaptation of patients after orthotopic cardiac grafts.

Adult↗
PubMed1985

Metabolic implications during a 20-km run after heart transplantation.

The aim of the present study was to evaluate a heart transplanted patient who ran a 20-km race 9 months after surgery. Thirty-six healthy male subjects were studied during the same run and served as control group. Biochemical variables were determined in blood and urine samples collected before and after the race. Post-exercise blood urea increased by 23% (P less than 0.05) in the control group but remained unchanged in the patient. Blood lactate increased far more in the transplanted patient (7.07 mmol/L) than in the control subjects (2.53 mmol/L). The exercise induced a 5.46- and 0.67-fold increase in creatine phosphokinase activity in the transplanted patient and control group, respectively. The creatinine and urea urinary excretion and clearance decreased by 40%-60% after exercise for all subjects. It may be concluded that the heart transplanted patient responded for most registered variables in the same way as normal subjects, but some differences occurred on the renal side due to the use of an immunosuppressive drug.

Blood Pressure↗
PubMed1985

Cyclosporine nephropathy after heart and heart-lung transplantation.

Cyclosporine nephrotoxicity after heart transplantation can lead to acute renal failure requiring haemodialysis. In four long-term heart-transplant survivors, cyclosporine nephropathy was characterised by extensive fibrosis, with uraemia, hypertension and/or anaemia. In contrast, the long-term survivor of heart-lung transplantation who had received her graft for accelerated respiratory failure, did not develop chronic renal disease. Thus, chronically reduced renal perfusion before heart transplantation may play a critical role in the development of chronic cyclosporine nephropathy.

Adult↗
PubMed1985

Combined heart-lung transplantation for terminal pulmonary lymphangioleiomyomatosis.

Combined heart-lung transplantation with cyclosporine is reported in a 26-year-old patient who presented with end-stage pulmonary lymphangioleiomyomatosis. The operation was successful and the patient's rehabilitation excellent over the first 7 postoperative months. She then developed obliterative bronchiolitis of unknown origin. To our knowledge, this is the first published report of an out-hospital survival after heart-lung transplantation for terminal nonvascular lung disease.

Adult↗
PubMed1983

Late prosthetic valve endocarditis: review of 19 cases and treatment.

Eighteen out of 1606 patients treated by valve replacement between January 1971 to June 1979 were admitted in Brugmann University Hospital for late prosthetic valve endocarditis. Of the 19 episodes (one patient had two distinct episodes four years apart), nine (group I) were treated medically and 10 (group II) by combined medical and surgical therapy. The infective organism was Staphylococcus epidermidis in two-thirds of our cases. Two cases in group I (22.2%) were long-term survivors. In group II, all 10 patients survived reoperation. There were four late deaths; six patients (60%) were still alive 1.8 to 4.4 years later (mean survival three years). Prompt prosthetic valve replacement is recommended in the presence of systemic emboli, evolving murmurs, uncontrolled sepsis or congestive heart failures (especially if the infective organism is a fungus or a staphylococcus), in late prosthetic valve endocarditis.

Endocarditis, Bacterial↗
PubMed1983

[Implantation of a cardiac pacemaker in the octogenarian].

Thirteen centres, specialized in pacemakers and studying the implantation, brought together their material. Consequently, 785 patients living with a pacemaker (PM) were grouped. The average age at the time of the first implantation is 83,5 years old. The mortality of 7.5% as well as the morbidity of 16% lie very low. Nevertheless, their causes are discussed and compared to those resulting from other types of surgical pathologies on the octogenarian. It seems that the implantation of a PM, even on a person of 80 or older, is an efficient therapeutic gesture, benign and capable of normalizing the chances and quality of life on a long term basis.

Aged↗
PubMed1982

Aspergillus osteochondritis after median sternotomy. Combined operative treatment and drug therapy with amphotericin B.

A case of Aspergillus fumigatus osteochondritis after median sternotomy for open heart surgery is presented. To the best of our knowledge, it is the second well documented case that has been reported in the literature. Successful healing was obtained with combined operative treatment (consisting of a large resection of the 8th, 9th and 10th right costal cartilages and surrounding soft tissues), and systemic drug therapy with Amphotericin B. Repeated serologic studies and bone scans were used for both the diagnosis and monitoring of the evolution of the infection; these 2 tools are recommended in cases of mycotic infections in that area.

Amphotericin B↗
PubMed1982

Traumatic rupture of the ascending aorta: a case report.

A patient with a rupture of the ascending aorta after a non-penetrating chest trauma is presented. The aortic tear, angiographically demonstrated, was situated just above the left coronary ostium. Only three examples of angiographically established cases of rupture of the ascending aorta were found in the literature. The point that the distal tip of the catheter should be placed proximally in the ascending aorta, is emphasized After operation the patient went well.

Accidents, Traffic↗